rface of the epiglottis; (b) as a
relatively small discrete growth on the ary-epiglottic fold; and (c) as an
isolated ulcerative growth on the false cord.
The supraglottic space has a rich lymphatic drainage and a high proportion
of these tumours spread to lymph nodes. Roughly 1 in 3 epiglottic tumours,
3 out of 4 ary-epiglottic tumours and about half the false cord tumours
metastasize. Nearly all these tumours will invade the pre-epiglottic space but
only a small proportion will involve the vocal cords until late in the course of
the disease. This fact makes partial laryngectomy a distinct possibility in
supraglottic cancer.
SYMPTOMS. These tumours do not affect the vocal cord and so rarely present
with hoarseness. If the tumour is very large there will be some muffling of the
voice. Occasionally the ary-epiglottic tumours will present with painful
dysphagia or on account of a lump in the neck from a metastatic gland. In
other words, these tumours are often diagnosed late since the supraglottis is
not a region to give rise to early symptoms. Sometimes, in fact, tumours in the
supraglottis axe discovered accidentally by an anaesthetist during intubation
for another procedure.
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